The idea of using proteinases to do solid-tumor microsurgery has led to the discovery of a new class of drugs that can eliminate solid-tumors by destroying the solid-structure of the main tissue of the tumor and kill actively-dividing cells locally(2). Basically, proteinases are employed to digest extracellular proteins including the extracellular domains of cell membrane proteins within a tumor. This kills actively dividing cells including cancer cells locally so as to eliminate a tumor as an organ. Desired outcomes are to eliminate tumor organs before cancer metastasis. However, due to some known reasons (such as irregular tumor shapes, locations, types and stages of the cancer, metastasis, proteinase species used and the surrounding tissue or organ microenvironment around the tumor) and other unknown reasons, the proteinase biochemotherapy may not be able to kill all cancer cells, especially in cases of metastasis. The untreated cancer cells may continue to grow and to metastasize to form new tumor organs. If the immune system is programmed with information against cancer cells by previous vaccination with a cancer vaccine, the proteinase biochemotherapy would be more effective because the immune system will kill any untreated or metastasized cancer cells for potential cure.
Cancer causes, types, races, diagnoses, treatments and challenges have been previously described(1, 2). However, challenges in developing an immunotherapy to treat cancer patients can be further addressed. First of all, a solid-tumor is an organ composed of a main tissue of cancer cells packed and networked together by over-expressed extracellular proteins which form a solid structure, and sporadic tissues of actively-dividing normal cells and blood vessels. Sporadic tissues were recruited by the main tissue to support the growth of the tumor organ. Secondly, the solid-structure of the main tissue of the tumor organ traps macrophages to disrupt their antigen-presentation processes. Thirdly, the tumor organ expresses and over-expresses cytokines and interleukins that drive immune screening cells including dendritic cells, B-cells, T-cells, natural killer cells and monocytes away from the organ. These events further disrupt the immune system's antigen sampling and presentation processes. Fourthly, the expression and over-expression of self-recognition molecular patterns by cancer cells prevents the immune system from obtaining cancer cells' mutation information. Thus, chemotherapy small molecules, immunotherapy monoclonal antibodies and T-cells are not effective enough against cancer if the tumor organ is not disrupted or eliminated. Proteinase-based biochemotherapy can quickly (within hours) and effectively eliminate the malignant solid-tumor organ locally(2). However, the immune system takes weeks to work pro-actively against cancer cells. There is an urgent need to pre-program the immune system to fight against cancer cells more quickly. Furthermore, the difference between extracellular matrices of cancer cells and that of actively dividing normal cells is not significant enough for the immune system to recognize. There is a great need to alter the self-recognition molecular patterns on the surfaces of cancer cells and expose their cancer cell specific mutation information for the body's immune system (via various lymphocytes) to recognize, sample, present, compare, process and eventually memorize in order to make cancer vaccine induced immune responses working against cancer cells.